Sections 38.2-3559 through 38.2-3562 of the Code of Virginia relating to health carriers, expedited reviews of adverse coverage determinations, exhaustion of internal reviews and cancer patients was enacted on April 3, 2019. To view the enacted bills, please click here.
A bulletin was issued regarding the Annual Survey on Health Insurance requirement that is applicable to all insurers authorized to transact health insurance business in the state of Alaska and other interested parties. To view the bulletin, please click here.
The United States District Court for the Northern District of California recently held that United Behavioral Health illegally denied mental health and substance use coverage based on flawed medical necessity criteria. To view the full decision, please click here.
The 2017 Maryland Report on the Health Care Appeals & Grievances Law, MSAR #6, was recently issued on December 1, 2018. To view the report, please click here.
Section 4530.40 has been amended to make the deadline for health carriers to submit an external review report to the Director of Insurance consistent with PA 99-537, which became effective January 1, 2017. To view the amendment, click here.
Part 4520 has been amended to recognize the Accreditation Association for Ambulatory Health Care among the list of accreditors from which utilization organizations may receive accreditation and qualify for reduced registration and renewal fees. To view these amendments, click here.
On October 11, 2018, Commissioner of Workers’ Compensation Cassie Brown adopted amendments to 28 Texas Administrative Code (TAC) §134.600, Preauthorization, Concurrent Utilization Review, and Voluntary Certification of Health Care. The adopted amendments were filed with the Office of the Secretary of State on October 12, 2018, and published in the October 26, 2018 issue of the Texas Register. […]
Rhode Island Department of Health is proposing to repeal 216-RICR-40-10-20 because the statutory authority under which it was created has been repealed and transferred to the Rhode Island Office of the Health Insurance Commissioner. To view the status of this regulation, click here.
The New Jersey Department of Banking and Insurance, Division of Insurance, Consumer Protection Services, Office of Managed Care, issued its semi-annual report to the Legislature on activities related to the Independent Health Care Appeals Program from January 1, 2018 through June 30, 2018. To view the report, click here.
2018 La. SB 336, effective date June 30, 2018, amended Louisiana Annotated Statutes, Louisiana Revised Statutes, Title 23 Labor and Workers’ Compensation, Chapter 10 Workers’ Compensation, Part 2 Benefits, Subpart A General Provisions – La. R.S. 23:1203.1. Applicable sections were updated in the Louisiana WCUM module page; however, to review the entire enacted bill, click […]